Nursing intervention to monitor abdominal hypertension from bleeding in patients with abdominal injury: Case studies comparing 2 patients

Abstract

This study aims to compare data on the disease progress, treatment, nursing diagnoses, and nursing outcomes of two patients with abdominal injuries receiving care at the Trauma Surgical Intensive Care Unit I, Khon Kaen Hospital during October 2019 and September 2021 and to identify nursing intervention guideline in monitoring abdominal hypertension related to bleeding and fluid loss. Data were collected from patient’s medical records, observation of patient care, and interviews with the patients and relatives. FANCAS critical care assessment framework was used to identify nursing diagnoses.Results indicated that abdominal injury was a critical condition and often involved hypovolemic shock.  Nursing care of patients required measurement of intra-abdominal pressure every 6 hours to monitor abdominal hypertension from bleeding in both non-operated and operated patients together with vital signs monitoring.Physicians were immediately notified when abnormalities were detected to prevent acute kidney injury from abdominal compartment syndrome (ACS) which would lead to multiple organ failure (MOFs) and death.Prompt diagnosis with quick treatment together with the nursing intervention was delivered to ensure patients safety from complications during the 3 phases including 1) the emergency phase, 2) critical phase,the  and 3) rehabilitation phase. Results from this study suggest the need to develop a nursing practice guideline to monitor acute kidney injury using shock index (SI) in assessing the patients and guiding treatment of patients with abdominal injury from accidents.